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目的:对羟考酮控释片用于晚期肿瘤合并中重度癌痛患者时的剂量滴定、不良反应、生活质量变化及长期用药的安全性进行临床分析。方法:85例患者应用羟考酮控释片逐步滴定至疼痛评分(NRS)在3以下,记录起始剂量、起效时间、滴定达稳态时间、不良反应及其生活质量情况。结果:82例完成剂量滴定,达到了满意的疼痛缓解。68例患者(82.9%)在60 min内起效,平均起效时间46.3 min。78例(95.1%)患者镇痛持续时间可达12 h。49例(59.8%)患者发生至少1种不良反应。不良反应主要为便秘(49.4%)、恶心呕吐(10.6%)、头晕(5.9%)、排尿困难(4.7%)等,大部分患者经对症治疗可耐受。患者停药后未见成瘾。用药前后患者的生活质量明显改善(P<0.01)。结论:羟考酮控释片可单独使用或与其他非阿片类镇痛药合用作为中重度癌痛患者的初始治疗和维持治疗,也可以作为治疗爆发性疼痛的即时给药。羟考酮控释片对各种性质疼痛疗效无明显差别,长期用药安全,不良反应可耐受,可以明显改善患者生活质量。
OBJECTIVE: To analyze the dosimetry, adverse reactions, quality of life changes and long-term safety of oxycodone controlled-release tablets in patients with advanced cancer with moderate to severe cancer pain. Methods: Eighty - five patients were titrated gradually until the pain score (NRS) was below 3 with oxycodone controlled release tablets. The initial dose, the onset time, the steady state titration time, adverse reactions and their quality of life were recorded. RESULTS: Eighty-two completed dose titrations achieved satisfactory pain relief. 68 patients (82.9%) onset within 60 min, the average onset time of 46.3 min. 78 patients (95.1%) patients with analgesia lasting up to 12 h. At least 1 adverse reaction occurred in 49 patients (59.8%). The main adverse reactions were constipation (49.4%), nausea and vomiting (10.6%), dizziness (5.9%) and dysuria (4.7%). Most patients were symptomatic and tolerable. No drug addiction after stopping patients. The quality of life of patients before and after treatment was significantly improved (P <0.01). CONCLUSION: Oxycodone controlled-release tablets can be used alone or in combination with other non-opioid analgesics as initial and maintenance treatment for patients with moderate-to-severe cancer pain and as an immediate medication for the treatment of explosive pain. Oxycodone controlled-release tablets on the pain of various properties no significant difference in efficacy, long-term medication safety, adverse reactions can be tolerated, can significantly improve the quality of life of patients.